From the Kuwait Times, a fascinating comparative analysis of the influence of Saudi Arabia and Qatar on Islamic countries in transitions:
Qatar losing ground to Saudi diplomacy
DUBAI: Qatar, a key supporter of Islamists who rose to power in Arab Spring countries, is losing ground in regional politics to Saudi Arabia which appears to have seized the reins on key issues, notably Egypt and Syria. The decline in Qatar’s regional diplomacy comes as its powerful emir Sheikh Hamad bin Khalifa Al-Thani unexpectedly abdicated in favor of his son Tamim last month.
The wealthy Gulf state had transformed itself into a key regional player but began to retreat as heavyweight Saudi Arabia re-entered the political arena after lagging behind in the immediate period following the eruption of the Arab Spring uprisings in December 2010. The ouster of Egypt’s Islamist president Mohamed Morsi last week by the army and the election by the Syrian opposition of Saudi-linked Ahmad Assi Jarba as new leader stripped Qatar of strong influence in both countries.
“Qatar had tried to take a leading role in the region but overstepped its limits by openly backing the Muslim Brotherhood in Egypt, Syria, and other Arab Spring states,” said Kuwaiti political analyst Ayed Al-Manna. Jonathan Eyal, head of international relations at Britain’s Royal United Services Institute, argued that Qatar’s regional politics have failed.
“Qatar’s Middle Eastern diplomacy now lies in ruins: it failed to produce dividends in Libya, backfired in Syria and has now collapsed in Egypt,” local Emirati daily The National quoted him on Tuesday as saying. Realizing the damaging effects of their policies, Manna noted, “the Qataris sought to cut down on their commitments” which were already affected by the emir’s abdication and the sidelining of the influential prime minister Sheikh Hamad Bin Jabr Al-Thani.
As a result, “Saudi Arabia, a historical regional US ally, regained its role” in coordination with other oil-rich Gulf monarchies, said Manna. Saudi Arabia’s King Abdullah was the first foreign head of state to congratulate Egypt’s interim president Adly Mansour, hours after he was named to replace Morsi. And on Tuesday, the kingdom pledged $5 billion in assistance to Egypt. The United Arab Emirates, which has cracked down on the Muslim Brotherhood in the past few months, offered Egypt an aid package of $3 billion.
“Saudi Arabia wants to ensure stability in Arab Spring countries, regardless of its ideological interests,” said analyst Abdel Aziz Al-Sagr, head of the Gulf Research Centre. “It had supported the Muslim Brotherhood in Egypt but reconsidered this support after the Brotherhood failed to run the country wisely,” he argued. But the Saudi researcher downplayed the rivalry between Saudi Arabia and Qatar, both of which have been looking to expand their influence during the Arab Spring uprisings and prevent any potential revolt against their own autocratic regimes.
“The Saudi-Qatari harmony still exists and there is no battle for influence between the two countries,” said Sager. And as proof, “Riyadh was the first to be informed of the political change in Qatar, six months before it took place. And it welcomed it.” But the two countries, whose relations have been historically tense or at least marked by mistrust, support two different approaches of political Islam that emerged strongly in the wake of the Arab Spring.
Qatar sides with political parties linked to the Muslim Brotherhood, whose experience was cut short despite the strong media support they enjoyed from the influential Doha-based Al-Jazeera news channel. Meanwhile, Saudi Arabia promotes Salafist groups that focus less on politics and more on implementing Shariah Islamic law on daily life matters such as forcing women to wear a veil and prohibiting the mixing between sexes. Saudi King Abdullah has reiterated his country’s stance against using Islam for political purposes.
“Islam rejects divisions in the name of one party or another,” he said in a statement marking the start Wednesday of the Muslim holy month of Ramadan. The kingdom will never accept” the presence of political parties, that “only lead to conflict and failure.” But regardless of the political agendas of Saudi Arabia or Qatar, the people who rose up during the Arab Spring revolts will have the final word on their own political futures, argued former Bahraini cabinet minister Ali Fakhro. “It is the Arab people, not Qatar nor Saudi Arabia, who will determine the political future of the region.” – AFP
July 11, 2013
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Cultural, Doha, ExPat Life, Interconnected, Kuwait, Leadership, Living Conditions, Political Issues, Saudi Arabia, Women's Issues | Arab Spring, Egypt, Muslim Brotherhood, Salafi, Sharia Law, Syria |
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Don’t you love technology? It’s like working on a complex puzzle, and all of a sudden seeing how disparate pieces relate 🙂 This is a fascinating discovery from AOL/Huffpost:
Ancient DNA Linked To Living Descendants In Genetic Study
The Huffington Post | By Macrina Cooper-White Posted: 07/09/2013 2:24 pm EDT | Updated: 07/09/2013 9:12 pm EDT
What if you could trace your ancestry back to around 5,000 years ago? Researchers were able to do just that in a fascinating new DNA study, which found adirect genetic link between the ancient remains of Native Americans and their living relatives.
“It’s very exciting to be able to have scientific proof that corroborates what our ancestors have been telling us for generations,” study co-author and participant Joycelynn Mitchell said in a written statement. “It’s very amazing how fast technology is moving to be able to prove this kind of link with our past.”
In the study, U.S. and Canadian researchers used mitochondrial genome (mitogenome) sequencing to analyze DNA inherited exclusively through mothers. Looking at the mitogenome is cheap, easier to sequence than nuclear DNA, and skirts around the problem that European men mixed with Native American women.
The researchers collected DNA from 60 living indigenous people belonging to the Tsimshian, Haida and Nisga’a tribes in the northern coast of British Columbia. The tribes’ oral histories and archaeological sites indicate they have lived in the region for generations, which made them good candidates for tracing their lineage back so many years.
Complete mitogenomes were extracted from the remains of four Mid-Holocene individuals found in British Columbia’s Lucy Islands and Dodge Island, and then that information was compared to the DNA of the study participants.
What was found? The research team discovered one of the living individuals carried this same “mitogenomic signature” as a young adult female who lived on Dodge Island 2,500 years ago — which also matched the mitogenome of the remains of a woman who lived in the Lucy Islands 5,500 years ago. Wow.
Three other living participants had mitogenomes that linked back to the remains of another individual found on Dodge Island, who may have lived around 5,000 years ago.
“This is the beginning of the golden era for ancient DNA research because we can do so much now that we couldn’t do a few years ago because of advances in sequencing technologies,” study co-author Dr. Ripan Malhi, an anthropology professor at the University of Illinois and Institute for Genomic Biology professor, said in a written statement. “We’re just starting to get an idea of the mitogenomic diversity in the Americas, in the living individuals as well as the ancient individuals.”
The new study was published online on June 3, 2013 in the journal PLoSONE.
July 10, 2013
Posted by intlxpatr |
Circle of Life and Death, Cultural, Family Issues, Generational, Interconnected, Local Lore, Relationships | British Columbia, Dodge Island, Haida, Lucy Islands, mitogenome, Nisga, Tsimshian |
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From the Daily Mail (UK)
The countries which contain the heaviest and lightest citizens can be revealed today.
This extraordinary graphic shows the average body mass index values for adults around the globe – with some surprising results.
With its wealthy society and love of fast food outlets, many would place the U.S. at the top of the list.
But it is pipped to first place in the body mass index chart by Kuwait. The Arab state has an average body mass index of 27.5 for men and 31.4 for women.
This beats America in second place which averages 26.5 for men and 29 for women.
From UPI:
Mexico is world fattest nation, United States No. 2
UNITED NATIONS, July 10 (UPI) — Officials at the U.N. Food and Agricultural Organization say Mexico with a 32.8 percent adult obesity rate is the most overweight of the industrialized nations.
Previously, the United States with an adult obesity rate of 31.8 percent was the world’s fattest nation. Last year, the percentage of U.S. adults overweight went down slightly.
A report by the FAO said Mexico’s widely available inexpensive junk food and penetration of U.S. fast-food chains combined with a more sedentary lifestyle all contributed to Mexico’s bulging waistline.
About 70 percent of Mexican adults are overweight, while childhood obesity tripled in a decade and about a third of teenagers are overweight as well, the Global Post said.
Weight-related diabetes claims 1-of-6 one of Mexican adults — or 70,000 people a year — suffering from the disease each year, the report said.
July 10, 2013
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Cross Cultural, Cultural, Eating Out, Food, Health Issues, Kuwait | BMI, Mexico, Obesity, United States |
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This is from the Huffington Post via AOL. Ramadan has started in the USA, but the rest of the world . . . not so clear.
Is Ramadan Tuesday or Wednesday? How about Thursday?
Because of disagreements over when the lunar-based Islamic fasting month begins, Muslims will start their fasting on different days this year.
In the United States, the Fiqh Council of North America, a prominent group of Islamic scholars affiliated with the Islamic Society of North America, has declared the first fasting day of Ramadan to be Tuesday. It used astronomical calculations and a sighting of the new moon in California. Many mosques, such as the Islamic Society of Boston Cultural Center, have also encouraged their congregants to use Tuesday as the first fasting day.
But with the vast majority of the world’s Muslims living outside the U.S., and many of America’s Muslims having immigrated from or having family in other countries, the Ramadan calendars used in places such as the Middle East and South Asia have swayed some Americans to change their observation dates.
In several Middle Eastern countries, including Saudi Arabia and United Arab Emirates, Islamic leaders said Monday that the new moon had not been sighted, meaning that Ramadan fasting could not begin until Wednesday. Ramadan technically begins at nighttime, when the crescent moon is sighted, and the first day of fasting begins at dawn the following morning. Islamic leaders in Malaysia have also said the fast won’t start until Wednesday. To blame in some areas for the lack of a visible moon: cloudy skies and bad weather.
In Pakistan, news sources are reporting that the fast could begin either Wednesday or Thursday. The story is similar in India, which is home to 177 million Muslims. TheWall Street Journal reported Tuesday that monsoons had prevented moon-sighting committees from declaring the beginning of Ramadan.
Syed Tariq Bukhari, a member of the moon sighting committee at Old Delhi’s Jama Masjid, one of India’s largest mosques, said India lags behind the Middle East because of its geographical position and, this year, because of the monsoon.According to his committee, if the new moon is spotted either by a moon sighting committee, a reliable Islamic witnesses — a Muslim man with a beard — or a large number of people Tuesday evening, then Ramadan will begin in India on Wednesday.
If not, then Thursday will mark the start of the fast.
Regardless of differing dates abroad, American Islamic scholars are keeping with using Tuesday as the first fast, Fiqh Council of North America officials say in a statement on their website.
“There is a big chance of divergence. The Fiqh Council will stick to its criteria and decision no matter what reports come from abroad. Ramadan in North America will definitely begin on Tuesday, July 9, 2013.”
July 9, 2013
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Ramadan, Technical Issue |
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“I miss the highs. . . ” my friend said – just before she went off her meds.
I totally understood what she was saying. We belonged to a quilting group, and when she was beginning a manic phase, she produced knock-out quilts, quilts combining colors in unusual ways, and she could stay up all night to finish one. She was a lot of fun to be around, totally up and enthusiastic and creative. As the phase progressed, however, she got thinner and thinner, fell in love with the wrong men, and I always knew when she was just about to crash because she looked fabulous – new clothes, lots of shoes, and she talked a mile a minute.
Then the crash. Her biggest fear was the credit card bills; when she was on a high, she felt like it didn’t matter. When she slid into depression, it was complicated by the fact that she had real things to be depressed about – STDs, huge bills, and concerns at her workplace and her security clearance.
As long as she was on her meds, she was fine, but the medications made her feel sluggish; she said even colors were less colorful on her meds. She said it was like spending your life underwater, where things were not so clear. She said it was dull.
It’s easy, when you are not bi-polar, to say “stay on your meds.” It’s really hard to do it when the meds can make you feel like you are living in a prison.
My friend recommended a book by Kay Redfield Jamison called An Unquiet Mind. It was one of the most helpful books I have ever read, helping me to understand just how hard it is to give up the mania in spite of the huge price you pay for it with the depressions.
I hope my friend is still alive.
This article is from AOL Health News:
4 Surprising Signs of Bipolar Disorder
Fewer than half of Americans with bipolar disorder are properly diagnosed and treated, recent research shows. Could you spot bipolar symptoms – in yourself or in someone close to you?
Many people with bipolar disorderdon’t even know they have it.
Fewer than half of people in the United States who show classic signs of bipolar disorder actually get diagnosed and treated, says a recent Archives of General Psychiatry report on a survey of more than 61,000 adults in 11 countries — the United States, Mexico, China, Japan, Brazil, Colombia, India, Lebanon, Bulgaria, Romania, and New Zealand. Bipolar patients in lower-income nations get even less treatment — in some cases, as few as 25 percent receive help.
Compared to the other 10 countries studied, the United States had the highest rate of bipolar disorder (4.4 percent of those surveyed fell somewhere on the bipolar spectrum). India had the lowest (0.1 percent). Overall, about 2.4 percent of those interviewed in the face-to-face survey could be classified as having bipolar disorder.
Bipolar Disorder’s Most Surprising Symptoms
It may be buzz-worthy these days, but many people don’t fully understand bipolar disorder and the symptoms that can lead to proper diagnosis and treatment. Bipolar, also sometimes called manic-depressive disorder, is characterized by shifts from extreme highs (known as mania) to emotional lows (depression), with “normal” moods in between.
It’s bipolar disorder’s manic phase that most sets it apart from other common mental health issues, such as depression and anxiety. While many people associate mania with high energy and exaggeratedly good moods, these other key symptoms are more subtle:
- Reckless spending. If a friend is blowing her paycheck on shopping sprees she can’t afford, watch out. A person in a manic phase of bipolar disorder is more likely to take big risks, including spending splurges that can lead to mountains of unmanageable debt.
- Super-charged sex drive. A sudden revving up of a person’s sex drive, obsessively thinking or talking about sex, or engaging in sexual encounters he otherwise wouldn’t (like a one-night stand or sex with someone he doesn’t know well) are all symptoms of hypersexuality, another less-obvious mania clue.
- Alcohol or drug abuse. These often go hand-in-hand with manic episodes: As many as 60 percent of people with bipolar disorder have abused alcohol or drugs at some point in their lives. Depressants such as alcohol or pain pills can send a person with mania straight into depression, while stimulants like cocaine can have the opposite effect.
- Skimping on shut-eye. Little need for sleep is another red flag that a person may be having a manic episode.
Keep in mind that bipolar disorder can vary greatly in severity, and not everyone experiences every symptom. In fact, some patients experience hypomania, a less mild form of mania. But even hypomania, if left untreated, could spin into depression or develop into full-blown mania.
One important takeaway from the Archives study is that across all countries, patients with bipolar disorder faced challenges in their daily lives and were at increased risk of such health problems as panic attacks, substance abuse, and suicide. Untreated bipolar disorder can also lead to troubled relationships with friends and family and problems at work. If you’re concerned about yourself or a friend or loved one, get more information here on the best treatments for bipolar disorder.
Last Updated: 08/08/2012
July 9, 2013
Posted by intlxpatr |
Arts & Handicrafts, Character, ExPat Life, Financial Issues, Germany, Health Issues, Relationships | bipolar disorder, manic-depression, Mental health issues |
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Usually by this time of the day, mid-afternoon, the majority of my viewers are US . . . guessing this is a Ramadan blip:
July 8, 2013
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Ramadan, Statistics |
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My first Ramadan was in Tunisia. It was summer, it was hot, and the days were long. The days dragged by, and then, in the evenings, our neighbors would send over huge platters of lamb and couscous, hot and spicy, to share with us. Our neighbors had ten children, all around our age, some older, some younger, and cars would arrive endlessly, bringing and taking people. They often included us in the family gatherings, out of the kindness and generosity of their hearts.
I didn’t understand how it all worked, Ramadan and fasting, and they would explain it to me. It’s a lot to take in. It took me a long time, many years, many Muslem countries, many Muslim friends. I still don’t think I understand all of it, but I understand enough of it to know this – it’s like a month of Christmas Eves.
A good Muslim won’t just fast from sunrise to sundown. A good Muslim circumcises his or her heart in this time. A good Muslim will read through the entire Quran at least once during Ramadan. The whole point of the sacrifice is to purify the soul.
I wish for my Muslim friends a joyful Ramadan, full of blessings. May God our Creator and Heavenly Father receive your sacrifice and bless your fasting. May your Mama prepare all your favorite foods for the breaking of the fast. 🙂
July 8, 2013
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Community, Cross Cultural, Cultural, ExPat Life, Faith, Ramadan, Tunisia |
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Technically, those who are ill are not required to fast, but my diabetic friends have said they can fast if they do it cautiously. I found this fascinating report on diabetics and fasting, particularly Ramadan fasting. You can reference the website Islam.ru.
Source:By: Fereidoun Azizi, MD, and Behnam Siahkolah, MD,/ Intl. Journal of Ramadan Fasting Research* / islamicity.com/October 31/2002 , res
Several of the world’s great religions recommend a period of fasting or abstinence from certain foods. Of these, the Islamic fast during the Muslim month of Ramadan is strictly observed every year. Islam specifically outlines one full month of intermittent fasting. The experience of fasting is intended to teach Muslims self-discipline and self-restraint and remind them of the plight of the impoverished. Muslims observing the fast are required to abstain not only from eating and drinking, but also from consuming oral medications and intravenous nutritional fluids.
The month of Ramadan contains 28 days to 30 days. The dates of observance differ each year because Ramadan is set to a lunar calendar. Fasting extends each day from dawn until sunset, a period which varies by geographical location and season. In summer months and northern latitudes, the fast can last up to 18 hours or more. Islam recommends that fasting Muslims eat a meal before dawn, called “sahur.” Individuals are exempt from Ramadan fasting if they are suffering from an illness that could be adversely affected by fasting. They are allowed to restrain from fasting for one day to all 30 days, depending on the condition of their illness. People diagnosed with diabetes fall into this category and are exempt from the fasting requirement, but they are often loathe to accept this concession. Physicians working in Muslims countries and communities commonly face the difficult task of advising diabetic patients whether it is safe to fast, as well as recommending the dietary and drug regimens diabetics should follow if they decide to fast. The lack of adequate literature on this subject makes it difficult to answer these questions. To judge correctly whether to grant medical permission to fast to a diabetic patient, it is essential physicians have an appreciation of the effect of Ramadan fasting on the pathophysiology of diabetes mellitus. In this article, we first review principles of carbohydrate metabolism and alterations of certain biochemical variables in diabetics observing Ramadan fasting. We then overview current medical recommendations that allow certain diabetic patients to fast and outline terms for diabetic patients, particularly IDDM patients, who should not fast but insist on fasting.
THE PHYSIOLOGICAL STATE OF DIABETICS DURING RAMADAN
Carbohydrate metabolism during Ramadan fasting in healthy persons
The effect of experimental short-term fasting on carbohydrate metabolism has been extensively studied (1,2). It has been uniformly found that a slight decrease in serum glucose to 3.3 mmol to 3.9 mmol (60 mg/dl to 70 mg/dl) occurs in normal adults a few hours after fasting has begun. However, the reduction in serum glucose ceases due to increased gluconeogenesis in the liver. That occurs because of a decrease in insulin concentration and a rise in glucagon and sympathetic activity (3). In children aged one years to nine years, fasting for a 24-hour period has caused a decrease in the blood glucose to half of the baseline figure for normal children of that age group. In 22% of these children, blood glucose has fallen below 40 mg/dl (4). Few studies have shown the effect of Ramadan fasting on serum glucose (5-9). One study has shown a slight decrease in serum glucose in the first days of Ramadan, followed by normalization by the twentieth day and a slight rise by the twenty-ninth day of Ramadan (6). The lowest serum glucose level in this study was 63 mg/dl. Others have shown a mild increase (7) or variation in serum glucose concentration (8,9), but all of them fell within physiological limits (6). From the foregoing studies, one may assume that the stores of glycogen, along with some degree of gluconeogenesis, maintain normal limits of serum glucose when a fast follows a large pre-dawn meal. However, slight changes in serum glucose may occur in individuals depending upon food habits and individual differences in metabolism and energy regulation.
Body weight during Ramadan fasting
(a) In normal subjects:
Weight losses of 1.7 kg. (10), 1.8 kg. (11), 2.0 kg. (12) and 3.8 kg (13) have been reported in normal weight individuals after they have fasted for the month of Ramadan. In one study that was over-represented by females, no change in body weight was seen (14). It has also been reported that overweight persons lose more weight than normal or underweight subjects (12).
(b) In diabetics:
A review of literature shows controversy about weight changes in diabetics during Ramadan.(6,15-24). In one group of studies, patients had an increase in their weight (17,21). In another group, there were no change (15,19,22,23) or a decrease (6,16,18,20,24) in body weight. While no food or drink is consumed between dawn and sunset during the month of Ramadan, there is no restriction on the amount or type of food consumed at night (23,25). Furthermore, most diabetics reduce their daily activities (15,23) during this period in fear of hypoglycemia. These factors may result in not only a lack of weight loss, but also a weight gain in such patients(26). (See later discussion about nutrition and physical activity.)
Blood glucose variations during Ramadan fasting in diabetics
Most patients show no significant change in their glucose control (3,23,24,27). In some patients, serum glucose concentration may fall or rise (28-30). This variation may be due to the amount or type of food consumption, regularity of taking medications, engorging after the fast is broken, or decreased physical activities. In most cases, no episode of acute complications (hypoglycemic or hyperglycemic types) occurs in patients under medical management(9,15,16,22), And only a few cases of biochemical hypoglycemia without clinical hazards have been reported (17,19,25).
Other parameters of diabetes control during Ramadan fasting
In general, HbAIC values show no change or even improvement during Ramadan (15-18,20,22,23,25,27,28,32). Only two studies have reported slight increases in glycated hemoglobin levels (19,31). However, one report has emphasized the same increase in non-fasting patients as fasting patients (31), and the other has shown a return to initial levels immediately after the month of Ramadan (19).
The amount of fructosamine (17,22,24,30,32), insulin, C-peptide (23,30) also has been reported to have no significant change before and during Ramadan fasting.
Energy intake and serum lipid variables during Ramadan fasting in diabetics
The amount of Energy (calorie) intake have been reported in some of the literature, indicating a decrease in energy intake (24,28).
Most patients with non-insulin dependent diabetes mellitus (NIDDM, diabetes type II) and insulin dependent diabetes mellitus (IDDM, diabetes type I) show no change or a slight decrease in concentrations of total cholesterol and triglyceride (15-19,27,28,32). Increase in total cholesterol levels during Ramadan seldom occurs (23). As in healthy persons (33-36), few studies have reported increases in high-density-lipoprotein (HDL) cholesterol in diabetics during Ramadan (18,19,27). One report indicates an increase in low-density-lipoprotein (LDL) cholesterol and a decrease in HDL-cholesterol (28). Until there is a standardization of diabetes Ramadan research in three fundamental factors — the Three D Triangle of drug regimens, diet control and daily activity — the benefits or hazards of Ramadan fasting on diabetics serum lipids is unclear.
Other biological parameters during Ramadan fasting in diabetics
Serum creatinine, uric acid, blood urea nitrogen, protein, albumin, alanine amino-transferase, aspartate amino-transferase values do not show significant changes during the fasting period(15,17,32). Slight non-significant increases in some biological parameters may be due to dehydration and metabolic adaptation and have no clinical presentation.
FASTING GUIDELINES TO DIABETICS
During the last two decades, a better understanding of pathophysiological changes during Ramadan fasting in diabetic patients has provided a few guidelines on how to advise diabetics who want to fast. Physicians working with Muslim diabetics should employ certain criteria to advise their patients regarding the safety of Ramadan fasting.
The following criteria should be helpful in making such a decision (20,37):
Forbid fasting in:
- All brittle type I diabetic patients;
- Poorly controlled type I or type II diabetic patients;
- Diabetic patients known to be incompliant in terms of following advice on diet drug regimens and daily activity;
- Diabetic patients with serious complications such as unstable angina or uncontrolled hypertension;
- Patients with a history of diabetic ketoacidosis;
- Pregnant diabetic patients;
- Diabetic patients will inter-current infections;
- Elderly patients with any degree of alertness problems;
- Two or more episodes of hypoglycemia and/or hyperglycemia during Ramadan.
Allow fasting in:
- Patients who do not have the aforementioned criteria;
- Patient who accept medical advisement.
Encourage fasting in:
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All overweight NIDDM patients (except for pregnant or nursing mothers) whose diabetes is stable with weight levels 20% above the ideal weight or body mass index (body weight, kg/height, meters squared) greater than 28.
EDUCATION OF THE DIABETICS BEFORE RAMADAN
NIDDM patients and IDDM patients who insist on fasting should be given a few recommendations about fasting (16). They should be forbidden from skipping meals, taking medication irregularly or gorging after the fast is broken (26).
The principles of pre-Ramadan considerations are (37):
- assessment of physical well being;
- assessment of metabolic control;
- adjustment of the diet protocol for Ramadan fasting;
- adjustment of the drug regimen e.g. change long-acting hypoglycemic drugs to short-acting drugs to prevent hypoglycemia);
- encouragement of continued proper physical activity;
- recognition of warning symptoms of dehydration, hypoglycemia and other possible complications.
RECOMMENDATIONS DURING RAMADAN FASTING
I. Nutrition and Ramadan fasting:
Dietary indiscretion during the non-fasting period with excessive gorging, or compensatory eating, of carbohydrate and fatty foods contributes to the tendency towards hyperglycemia and weight gain (21,23). It has been emphasized that Ramadan fasting benefits appear only in patients who maintain their appropriate diets (24,38,39). Thus, in order to optimize control, diabetics must be reminded to abstain from the high-calorie and highly-refined foods prepared during this month (38).
II. Physical activity and Ramadan fasting:
Several studies indicate that light to moderate regular exercise during Ramadan fasting is harmless for NIDDM patients (15). It has been shown that fasting does not interfere with tolerance to exercise (40). It should be impressed upon diabetic patients that it is necessary to continue their usual physical activity especially during non-fasting periods (41)
III. Drug regimens for IDDM patients:
Some experienced physicians conclude Ramadan fasting is safe for IDDM patients with proper self-monitoring and close professional supervision (16). It is fundamental to adjust the insulin regimen for good IDDM control during Ramadan fasting. Two insulin therapy methods have been studied successfully:
-
Three-dose insulin regimen: two doses before meals (sunset and Dawn) of short-acting insulin and one dose in the late evening of intermediate-acting insulin (16).
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Two-dose insulin regimen: Evening insulin combined with short-acting and medium-acting insulin equivalent to the previous morning dosage, and a pre-dawn insulin consisting only of a regular dosage of 0.1-0.2 unit/kg (25).
Home blood glucose monitoring should be performed just before the sunset meal and three hours afterwards. It should also be performed before the pre-dawn meal to adjust the insulin dose and prevent any hypoglycemia and post-prandial hyperglycemia following over-eating.
IV. Drug regimens for NIDDM patients:
Available reports indicate that there are no major problems encountered with NIDDM overweight patients who observe fasting in Ramadan (3). With proper changes in the dosage of hypoglycemic agents there will be low risk for hypoglycemia and hyperglycemia.
The authors of the largest series of patients treated with glibenclamide during Ramadan recommended that diabetics switch the morning dose (together with any mid-day dose) of this drug with the dosage taken at sunset (31).
V. Other health tips for reduction of complications:
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Implementation of the 3D Triangle of Ramadan — drug regimen adjustment, diet control and daily activity — as the three pillars for more successful fasting during Ramadan.
-
Diabetic home management that consists of:
– Monitoring home blood glucose especially for IDDM patients, as described above;
– Checking urine for acetone (IDDM patients);
– Measuring daily weights and informing physicians of weight reduction (dehydration, low food intake, polyuria) or weight increase (excessive calorie intake) above two kilograms;
Recording daily diet intake (prevention of excessive and very low energy consumption).
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Education about warning symptoms of dehydration, hypoglycemia and hyperglycemia.
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Education about breaking fast as soon as any complication or new harmful condition occurs.
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Immediate medical help for diabetics who need medical help quickly, rather than waiting for medial assistance the next day.
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Further attention on fasting during the summer season and geographical areas with long fasting hours.
VI. IDDM children and Ramadan fasting:
We do not encourage fasting for IDDM children. However, a few studies demonstrate that fasting is safe among diabetic adolescents. Of these studies, one study concludes that Ramadan fasting is feasible in older children and children who have had diabetes for a long time, and it concludes fasting does not alter short-term metabolic control. Nevertheless, fasting should only be encouraged in children with good glycemic control and regular blood glucose monitoring at home (25).
POST-RAMADAN SUPERVISION OF FASTING DIABETICS
After the month of Ramadan ends, the patients therapeutic regimen should be changed back to its previous schedule. Patients should also be required to get an overall education about the impact of fasting on their physiology (37).
THE RESEARCH METHODOLOGY ON DIABETICS DURING RAMADAN
From a methodological point of view, few research papers on Ramadan fasting are relevant because of the absence of control periods before Ramadan and afterwards, the absence of measurements during each week of Ramadan, a lack of attention to dietary habits, food composition, food value, caloric control, weight changes and the importance of the schedule during circadian periods.
It is recommended that all these factors should be taken into consideration and that all intervening and confounding variables should be under control. It is clear that more work should be done on Ramadan fasting to evaluate physiological and pathological changes with proper research methods (42).
Fasting during the entire month of Ramadan is reserved usually for healthy Muslims. However, many diabetic patients are allowed to fast periodically during Ramadan. The magnitude of periodic total fasting effect on blood glucose and hepatic glucagon depends on the number of fasting days (43), and this should be considered in all Ramadan fasting research activities.
CONCLUSION
The bulk of literature indicates that fasting in Ramadan is safe for the majority of diabetics patients with proper education and diabetic management. Most NIDDM patients can fast safely during Ramadan. Occasional IDDM patients who insist on fasting during Ramadan can also fast if they are carefully managed. Strict attention to diet control, daily activity and drug regimen adjustment is essential for successful Ramadan fasting.
To shed more light on pathophysiological changes in Ramadan fasting, in particular in Muslims diabetics, it is recommended that a multicentric international controlled clinical trial be employed to assess the effect of differences in gender, races, physical activities, food habits, sleep patterns and other important variables on physiologic and pathologic conditions during Ramadan fasting.
July 7, 2013
Posted by intlxpatr |
Food, Health Issues, Ramadan | diabetes, diabetics, fasting |
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A two and a half hour drive took us six hours. We also stopped for lunch, and we stopped to pick up the Qatari Cat. The rest of the time, we were stuck in bumper to bumper traffic most of the 100 something miles of the drive home; stuck in one lane even on four lane highways as the drains failed when there was so much rain and runoff that there was no where for it to go.
Leaving Panama City, the surf was high, and full of undertow.
We were able to get through the Watercolors/Seaside area quickly, and then the deluge:
When we had to go single file, most of the time everyone cooperated, letting people in from gas stations and side roads, taking turns, etc. Then, there are always those @$$&*!>$ who think everyone is being too cautious and polite, who break the line, go thundering up through the lake, discover no, no they really can’t make it and barge back into the line. Karma catches up with the arrogant.
The worst part, the very worst, was going past the SanDestin outlet malls; when the skies break forth and there is no possible point to being on the beach, the tourists head for the malls and the restaurants. The malls were booming! Traffic crawled by. Even the poorest restaurant was also full; thank God we were still full from breakfast.
This is the bridge leaving Destin; on the right side of the road in front of that stalled truck is about a huge puddle a foot deep:
Outside Navarre, both rain and traffic began to lighten up. We stopped at a little roadside place I’d always wanted to try for something that might have been our late lunch or our early dinner – TC’s Front Porch, it’s across from the Navarre Butterfly House.
There was a small crowd inside, guys hanging out at the bar, looked like fishermen waiting for it to clear up enough to go back out and catch some fish, some tables with college kids down on the beaches for summer break, maybe lifeguards – swimming not allowed with the heavy surf and heavy rip tides running.
Everyone pretty much just waiting out the storm, tossing back a few brews, just hanging out. I had some pretty good crab cakes and AdventureMan had the chili. It was all OK. Beach food.
The Qatari Cat was delighted to see us, and slept as close as he could to me all night (not such a great thing; I appreciate that he thinks I am special, but he is hot, and I can’t turn over without disturbing him . . . aarrgh) This morning, however, he ran and hid under the bed when he saw us getting ready to go out; we think he was afraid we were taking him back to Wee Tuck’Em Inn, LOL.
Here’s the thing. For us, we were just inconvenienced, and it was just minor inconvenience. We had the time, we knew beach traffic would be heavy, it was a little adventure.
For people who earn a living from tourism, for some of these people, this weekend was probably a disaster. The hotels are packed for the Fourth of July weekend, and lots of fireworks displays are planned, big entertainment – it’s a big money making time of the year. With the four day storm, some people probably cancelled hotel reservations, and when the rain didn’t stop, others left. Many of the July Fourth fireworks displays were cancelled. Local fests were rained out. I am guessing most of the malls and restaurants did OK; not much else to do, but it rained SO much that there is a lot of flooding and a lot of damage. This, for many people, was not a good weekend.
July 7, 2013
Posted by intlxpatr |
Adventure, Cultural, Environment, Road Trips, Travel, Weather | Navarre, SanDestin Outlet Malls, TC's Front Porch |
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When you read this article from the Kuwait Times, you will see that the requirements for obtaining a Kuwait driver’s license are not new, but enforcing the requirements – if it happens – will be new. It will make Kuwait more like Saudi Arabia for expat wives, where women cannot drive their own car to pick up the laundry or drop the kids off at school or go grocery shopping – unless, in the case of Kuwait, she has a university degree AND has lived in Kuwait for two years AND is employed earning 400KD. No mere expat wife will have a driver’s license under these guidelines.
But these are the same guidelines that were in effect when I arrived in Kuwait. When I was in Kuwait on a house hunting trip before moving there, I asked how this would work, with me not being able to have a license, according to the rules. I was asking Kuwaiti officials. They said that the rules did not apply to me. (This answer still stuns me.) So where is it written to whom the law applies? The office of the Interior Ministry for Traffic Affairs will have a great deal of leeway making their approvals – will they apply this law equally to all peoples of all nationalities?
No licenses without traffic chief’s nod
KUWAIT: The Interior Ministry’s Assistant Undersecretary for Traffic Affairs Maj Gen Abdulfattah Al-Ali issued a decision yesterday to stop the acceptance of applications for driving licenses from non-Kuwaitis (expatriates and bedoons) unless they are approved by his office. The decision number 61/2013 went into effect from July 1, 2013, and allows the undersecretary’s office to inspect every application forwarded by foreigners and stateless residents in order to verify whether they meet the conditions to apply for a driving license. Ali reportedly threatened traffic department officials with retribution if they fail to abide by the new instructions.
According to security sources who spoke to a local daily, the decision came after cases were discovered in which manipulations were found in some departments where licenses were issued to expatriates who do not meet the requirements. A foreign resident in Kuwait must have a university degree, a minimum monthly salary of KD 400 and have been residing in Kuwait for at least two years among other conditions to apply for a driving license.
The sources also argued that the new decision does not take away the authority of traffic departments around Kuwait. “The departments’ main role is to issue licenses to Kuwaitis, while issuing licenses to expatriates is the exception,” they said, adding the decision means transferring the exception to the assistant undersecretary’s office so that traffic department officials can focus on their jobs of serving citizens and putting more traffic police officers on the streets.
“Any decision – even if it’s for the safety and organization of traffic regulations in the country – issued suddenly without informing the public in advance will surely create hostility,” said attorney Labeed Abdal, a Kuwaiti columnist. “I advise the good undersecretary to hold a press conference to explain to the people why such a regulation is needed. In this way you send the message correctly to people who will not be angry or surprised,” he added. Abdal agreed that the decision is directed to ease traffic jams in the country blamed on reckless drivers. “I think the decision is good. Be informed that he (Ali) did not stop it completely – he said he will give a chance, under his ultimate mercy. He did this to avoid license forgery and wasta (influence),” he stressed.
Another Kuwaiti was not very happy about the new decision. “(A driving license) is the right of every human being…why can’t they understand this. This decision is short of saying ‘just terminate all the services of expatriates in Kuwait’. Why are expats here if you cannot provide the facilities they need. I ask the official (Ali) to try at least once to ride in a bus or even wait for a taxi. If he can stay for one minute under the scorching heat of the sun, then OK, cancel the licenses of expats. If not, forget about your decision – it’s inhuman and cannot be accepted,” he fumed.
I do not agree that a driving license is a right of every human being. I do believe that those under 18 should not be driving on the roads of Kuwait – I don’t mind them learning how to drive out in the desert, but save the testosterone driving for way out there where you can’t endanger the rest of us. I don’t believe people who don’t know the laws should have a license. I think there should be a test that every person can study for and must pass to have a driver’s license, otherwise you are simply saying that every human being has a right to a license to kill! I believe that every driver must be adequately insured to be licensed, and that the police must be impartial when determining fault in an accident. These are the rules that hold those responsible enough to drive the wild roads of Kuwait to be held accountable for their driving.
I applaud the sincerity with which Maj Gen Abdulfattah Al-Ali is striving to make the roads in Kuwait safer for all, and enforcing the law equally against all nationalities, even Kuwaitis. I hope he will remember transparency and accountability as he builds a truly modern and enforceable traffic system in Kuwait.
July 6, 2013
Posted by intlxpatr |
Cross Cultural, Cultural, Customer Service, ExPat Life, Family Issues, Financial Issues, Kuwait, Law and Order, Satire, Saudi Arabia, Social Issues, Transparency, Women's Issues, Work Related Issues | Driving in Kuwait, Maj Gen Abdulfattah Al-Ali |
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Here There and Everywhere 